Planned Parenthood consists of 159 medical and non-medical affiliates, which operate over 650 health clinics in the U.S.[2][3] It partners with organizations in 12 countries globally.[2][3] The organization directly provides a variety of reproductive health services and sexual education, contributes to research in reproductive technology, and performs advocacy work aimed at protecting and expanding reproductive rights.[3]

PPFA is the largest single provider of reproductive health services, including abortion, in the U.S.[8] In their 2014 Annual Report, PPFA reported seeing over 2.5million patients in over 4million clinical visits and performing a total of nearly 9.5million discrete services including 324,000 abortions.[11] Its combined annual revenue is US$1.3billion, including approximately US$530million in government funding such as Medicaid reimbursements.[3][10] Throughout its history, PPFA and its member clinics have experienced support, controversy, protests,[12] and violent attacks.[13]

Margaret Sanger (1922), the first president and founder of Planned Parenthood.

The origins of Planned Parenthood date to October 16, 1916, when Margaret Sanger, her sister Ethel Byrne, and Fania Mindell opened the first birth control clinic in the U.S. in the Brownsville section of the New York borough of Brooklyn.[14] They distributed birth control, birth control advice, and birth control information. All three women were arrested[15][16][17] and jailed for violating provisions of the Comstock Act, accused of distributing obscene materials at the clinic. The so-called Brownsville trials brought national attention and support to their cause. Sanger and her co-defendants were convicted on misdemeanor charges, which they appealed through two subsequent appeals courts. While the convictions were not overturned,[18] the judge who issued the final ruling also modified the law to permit physician-prescribed birth control. The women's campaign led to major changes in the laws governing birth control and sex education in the United States.[19]

In 1921 the clinic was organized into the American Birth Control League,[4] the core of the only national birth control organization in the U.S. until the 1960s. By 1941 it was operating 222 centers and had served 49,000 clients.[20] However, some found its title offensive and "against families", so the League began discussions for a new name.[21] In 1942 the League became known as the Planned Parenthood Federation of America.[21]

Largely relying on a volunteer workforce, by 1960 the Federation had provided family planning counseling in hundreds of communities across the country.[20] Planned Parenthood was one of the founding members of the International Planned Parenthood Federation when it was launched at a conference in Bombay (now Mumbai), India, in 1952.[20][22]

Both Planned Parenthood and Margaret Sanger are strongly associated with the abortion issue today.[23][24] For much of the organization's history, however, and throughout Sanger's life, abortion was illegal in the United States, and discussions of the issue were often censored.[25] During this period, Sanger - like other American advocates of birth control - publicly condemned abortion, arguing that it would not be needed if every woman had access to birth control.[25]

Following Margaret Sanger, Alan Frank Guttmacher became president of Planned Parenthood, serving from 1962 until 1974.[26] During his tenure, the Food and Drug Administration approved the sale of the original birth control pill, giving rise to new attitudes towards women's reproductive freedom.[20] Also during his presidency, Planned Parenthood lobbied the federal government to support reproductive health, culminating with President Richard Nixon's signing of Title X to provide governmental subsidies for low-income women to access family planning services.[27] The Center for Family Planning Program Development was also founded as a semi-autonomous division during this time.[28] The center became an independent organization and was renamed the Guttmacher Institute in 1977.[28]

Planned Parenthood began to advocate abortion law reform beginning in 1955, when the organization's medical director, Mary Calderone, convened a national conference of medical professionals on the issue. The conference was the first instance of physicians and other professionals advocating reform of the laws which criminalized abortion, and it played a key role in creating a movement for the reform of abortion laws in the United States.[25] Focusing, at first, on legalizing therapeutic abortion, Planned Parenthood became an increasingly vocal proponent of liberalized abortion laws during the 1960s, culminating in its call for the repeal of all anti-abortion laws in 1969.[29] In the years that followed, the organization played a key role in landmark abortion rights cases such as Roe v Wade (1973) and Planned Parenthood v Casey (1992).[24] Once abortion was legalized during the early 1970s, Planned Parenthood also began acting as an abortion provider.

A Planned Parenthood supporter participates in a demonstration in support of the organization

Faye Wattleton became the first African American president of the Planned Parenthood Federation of America in 1978. Wattleton, who was also the youngest president in Planned Parenthood's history, served in this role until 1992.[30][31] During her term, Planned Parenthood grew to become the seventh largest charity in the country, providing services to four million clients each year through its 170 affiliates, whose activities were spread across 50 states.[32]

From 1996 to 2006, Planned Parenthood was led by Gloria Feldt.[33][34] Feldt activated the Planned Parenthood Action Fund (PPAF), the organization's political action committee, launching what was the most far reaching electoral advocacy effort in its history.[35] The PPAF serves as the nonpartisan political advocacy arm of PPFA.[36] It engages in educational and electoral activity, including legislative advocacy, voter education, and grassroots organizing to promote the PPFA mission. Feldt also launched the Responsible Choices Action Agenda, a nationwide campaign to increase services to prevent unwanted pregnancies, improve quality of reproductive care, and ensure access to safe and legal abortions.[20] Another initiative was the commencement of a "Global Partnership Program", with the aim of building a vibrant activist constituency in support of family planning.[20]

In 2013PPFA reported seeing 2.7million patients in 4.6million clinical visits.[9] Roughly 16%of its clients are teenagers.[2][50] According to PPFA, in 2014 the organization provided 3.6 million contraceptive services, 4.5million sexually transmitted infection services, about 1million cancer related services, over 1million pregnancy tests and prenatal services, over 324,000 abortion services,[51] and over 100,000 other services, for a total of 9.5million discrete services.[9] PPFA is well known for providing services to minorities and the poor;[52][53] according to PPFA, approximately four out of five of their clients have incomes at or below 150percent of the federal poverty level.[48][54]

Given that each patient receives about three services on average, the percent of abortions provided out of the total services provided‍—‌3.4%‍—‌may not clearly represent the importance of abortion to PPFA.[55] Each year, 12percent of PPFA's patients gets an abortion,[56] which is expensive when compared with other services.[57][58]

PPFA has two national offices in the United States: one in Washington, D.C., and one in New York. It has three international offices, including a hub office in London, England. It has 68 medical and related affiliates and 101 other affiliates including 34 political action committees.[3] These affiliates together operate more than 700 health centers in all 50 states and the District of Columbia.[2][59][60] PPFA owns about US$54million in property, including real estate. In addition, PPFA spends a little over US$1million per year for rented space.[3] The largest facility, a US$26million, 78,000-square-foot (7,200-square-metre) structure, was completed in Houston, Texas, in May 2010.[61]

PPFA's international outreach and other activities are performed by Planned Parenthood Global, a division of PPFA,[3][62] and by the International Planned Parenthood Federation (IPPF) which now consists of more than 149 Member Associations working in more than 189 countries.[63] The IPPF is further associated with International Planned Parenthood Federation affiliates in the Caribbean and the Americas[64] and IPPF European Network,[65] as well as other organizations like Family Planning Queensland, Pro Familia (Germany) and mouvement français pour le planning familial (French Movement for Family Planning). Offices are located in New York, NY; Washington, DC; Miami, FL; Guatemala City, Guatemala; Abuja, Nigeria; and Nairobi, Kenya. The organization's focus countries are Guatemala, Nicaragua, Costa Rica, Ecuador, Peru, Senegal, Burkina Faso, Nigeria, Sudan, South Sudan, Uganda, Ethiopia, and Kenya.[66] The Bloomberg Philanthropies donated US$50million for Planned Parenthood Global's reproductive health and family planning efforts in Tanzania, Nicaragua, Burkina Faso, Senegal and Uganda.[67] Among specific countries and territories serviced by Planned Parenthood Global's reproductive planning outreach are Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Peru, Suriname, Venezuela, Puerto Rico, U.S. Virgin Islands, Dominican Republic, Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde and Samoa.[62][63]

Planned Parenthood has received federal funding since 1970, when President Richard Nixon signed into law the Family Planning Services and Population Research Act, amending the Public Health Service Act. Title X of that law provides funding for family planning services, including contraception and family planning information. The law had support from both Republicans and Democrats.[68] Nixon described Title X funding as based on the premise that "no American woman should be denied access to family planning assistance because of her economic condition".[69]

In the fiscal year ending June 30, 2014, total revenue was US$1.3billion: non-government health services revenue was US$305million, government revenue (such as Medicaid reimbursements) was US$528million, private contributions totaled US$392million, and US$78million came from other operating revenue.[70] According to Planned Parenthood, 59% of the group's revenue is put towards the provision of health services, while non-medical services such as sex education and public policy work make up another 15%; management expenses, fundraising, and international family planning programs account for about 16%, and 10% of the revenue in 2013–2014 was not spent.[70]

Planned Parenthood receives over a third of its money in government grants and contracts (about US$528million in 2014).[58][70] By law, federal funding cannot be allocated for abortions (except in rare cases),[71] but some opponents of abortion have argued that allocating money to Planned Parenthood for the provision of other medical services allows other funds to be re-allocated for abortions.[53]

A coalition of national and local pro-life groups have lobbied federal and state governments to stop funding Planned Parenthood. As a result, federal and state legislators have proposed legislation to reduce funding levels.[71][72] Eight states‍—‌Alabama, Arkansas, Indiana, Kansas, Louisiana, New Hampshire, Ohio, and Utah‍—‌have enacted such proposals.[83] In some cases the courts have overturned such actions, citing conflict with federal or state laws; in others the federal executive branch has provided funding in lieu of the states.[75][76][84] In some states, Planned Parenthood was completely or partially defunded.[85][86]

In August 2015, Louisiana Governor Bobby Jindal attempted to end Louisiana's contract with Planned Parenthood to treat Medicaid patients at a time when there was an epidemic of sexually transmitted diseases in Louisiana.[54] Planned Parenthood and three patients sued the state of Louisiana, with the United States Department of Justice siding with Planned Parenthood.[87]

On February 2, 2016, the U.S. House failed to override President Obama's veto of H.R. 3762 which would have prohibited Planned Parenthood from receiving any federal Medicaid funds for one year.[88]

Planned Parenthood is an advocate for the legal and political protection of reproductive rights.[95] This advocacy includes helping to sponsor abortion rights and women's rights events.[96] The Federation opposes restrictions on women's reproductive health services, including parental consent laws for minors.[97][98] To justify this position, Planned Parenthood has cited the case of Becky Bell, who died following an illegal abortion rather than seek parental consent for a legal one.[99][100] Planned Parenthood also takes the position that laws requiring parental notification before an abortion can be performed on a minor are unconstitutional on privacy grounds.[101]

The organization opposes laws requiring ultrasounds before abortions, stating that their only purpose is to make abortions more difficult to obtain.[102] Planned Parenthood has also opposed initiatives that require waiting periods before abortions,[103] and bans on late-term abortions including intact dilation and extraction, which has been illegal in the U.S. since 2003.[104] Planned Parenthood supports the wide availability of emergency contraception such as the PlanB pill.[105] It opposes conscience clauses, which allow pharmacists to refuse to dispense drugs against their beliefs.[106] Planned Parenthood has been critical of hospitals that do not provide access to emergency contraception for rape victims.[107] Citing the need for medically accurate information in sex education, Planned Parenthood opposes abstinence-only education in public schools. Instead, Planned Parenthood is a provider of, and endorses, comprehensive sex education, which includes discussion of both abstinence and birth control.[108]

Planned Parenthood's advocacy activities are executed by the Planned Parenthood Action Fund, which is registered as a 501(c)(4) charity, and files financial information jointly with PPFA.[3] The committee was founded in 1996, by then-president Gloria Feldt, for the purpose of maintaining reproductive health rights and supporting political candidates of the same mindset. In the 2012 election cycle, the committee gained prominence based on its effectiveness of spending on candidates.[109] Although the Planned Parenthood Action Fund (PPAF) shares some leadership with the Planned Parenthood Federation of America, the president of PPAF, Cecile Richards,[110][111] testified before Congress in September 2015 that she did not manage the organization.[112] The Planned Parenthood Action Fund has 58 active, separately incorporated chapters in 41 states[113] and maintains national headquarters in New York and Washington, D.C.[114] Planned Parenthood has received grants from the Obama administration to help promote the Patient Protection and Affordable Care Act, or ObamaCare.[115]

Planned Parenthood spends money on politics and elections through the Planned Parenthood Action Fund (its federal political action committee), through its Super PAC, and through a variety of related 501(c)(4) entities.[116] Planned Parenthood endorsed Barack Obama in the 2008 and 2012 presidential elections.[117][118] In the 2014 election cycle, Planned Parenthood spent US$6,587,100 on contributions to candidates and political parties (overwhelmingly to Democrats) and on independent expenditures.[116][119]

Planned Parenthood regional chapters have been active in the American courts. A number of cases in which Planned Parenthood has been a party have reached the U.S. Supreme Court. Notable among these cases is the 1992 case Planned Parenthood v. Casey, the case that sets forth the current constitutional abortion standard. In this case, "Planned Parenthood" was the Southeast Pennsylvania Chapter, and "Casey" was Robert Casey, the governor of Pennsylvania. The ultimate ruling was split, and Roe v. Wade was narrowed but upheld in an opinion written by Sandra Day O'Connor, Anthony Kennedy, and David Souter. Harry Blackmun and John Paul Stevens concurred with the main decision in separately written opinions. The Supreme Court struck down spousal consent requirements for married women to obtain abortions, but found no "undue burden"—an alternative to strict scrutiny, which tests the allowable limitations on rights protected under the Constitution—from the other statutory requirements. Dissenting were William Rehnquist, Antonin Scalia, Clarence Thomas, and Byron White. Blackmun, Rehnquist, and White were the only justices who voted on the original Roe v. Wade decision in 1973 who were still on the Supreme Court to rule on this case, and their votes on this case were consistent with their votes on the original decision that legalized abortion.[120] Only Blackmun voted to maintain Roe v. Wade in its entirety.[121]

Other related cases include:

Planned Parenthood of Central Missouri v. Danforth (1976). Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, spousal consent, clinic bookkeeping and allowed abortion methods. Portions of the challenged law were held to be constitutional, others not.[122]

Planned Parenthood Association of Kansas City v. Ashcroft (1983). Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, clinic record keeping, and hospitalization requirements. Most of the challenged law was held to be constitutional.[123]

Planned Parenthood v. ACLA (2001). The American Coalition of Life Activists (ACLA) released a flier and "Wanted" posters with complete personal information about doctors who performed abortions. A civil jury and the Ninth Circuit Court of Appeals both found that the materials were indeed "true threats" and not protected speech.[124]

Gonzales v. Planned Parenthood (2003). Planned Parenthood sued Attorney General Gonzales for an injunction against the enforcement of the Partial-Birth Abortion Ban Act of 2003. Planned Parenthood argued the act was unconstitutional because it violated the Fifth Amendment, namely in that it was overly vague, violated women's constitutional right to have access to abortion, and did not include language for exceptions for the health of the mother. Both the district court and the US Court of Appeals for the Ninth Circuit agreed,[125][126] but that decision was overturned in a 5–4 ruling by the Supreme Court.[127]

Ayotte v. Planned Parenthood of Northern New England (2006). Planned Parenthood et al. challenged the constitutionality of a New Hampshire parental notification law related to access to abortion.[128] In Sandra Day O'Connor's final decision before retirement, the Supreme Court sent the case back to lower courts with instructions to seek a remedy short of wholesale invalidation of the statute. New Hampshire ended up repealing the statute via the legislative process.[129]

Some state attorneys general have subpoenaed medical records of patients treated by Planned Parenthood. Planned Parenthood has gone to court to keep from turning over these records, citing medical privacy and concerns about the motivation for seeking the records.[130]

In 2006, Kansas Attorney GeneralPhill Kline, a Republican, released some sealed patient records obtained from Planned Parenthood to the public. His actions were described as "troubling" by the state Supreme Court, but Planned Parenthood was compelled to turn over the medical records, albeit with more stringent court-mandated privacy safeguards for the patients involved.[130] In 2007 Kline's successor, Paul J. Morrison, a Democrat, notified the clinic that no criminal charges would be filed after a three-year investigation, as "an objective, unbiased and thorough examination" showed no wrongdoing. Morrison stated that he believed Kline had politicized the attorney general's office.[131] In 2012 a Kansas district attorney found that the practices of the Kansas City-area Planned Parenthood clinic were "within accepted practices in the medical community" and dropped all of the remaining criminal charges. In all, the Planned Parenthood clinic had faced 107 criminal charges from Kline and other Kansas prosecutors, all of which were ultimately dismissed.[132]

In 2006, the Indiana Court of Appeals ruled that Planned Parenthood was not required to turn over its medical records in an investigation of possible child abuse.[133] In 2005 Planned Parenthood Minnesota/North Dakota/South Dakota was fined US$50,000 for violating a Minnesota state parental consent law.[134]

In 2012, a Texas state court judge, Gary Harger, denied Planned Parenthood request for a temporary restraining order against the State of Texas, concluding that the State may exclude otherwise qualified doctors and clinics from receiving state funding if the doctors or clinics advocate for abortion rights.[135]

In the 1920s, various theories of eugenics were popular among intellectuals in the United States. (For example, 75% of colleges offered courses on eugenics.)[136] In her campaign to promote birth control, Sanger teamed with eugenics organizations such as the American Eugenics Society, although she argued against many of their positions.[137][138] Scholars describe Sanger as believing that birth control and sterilization should be voluntary, and not based on race.[139] Sanger advocated for "voluntary motherhood"—the right to choose when to be pregnant—for all women, as an important element of women's rights.[140][141] As part of her efforts to promote birth control, however, Sanger found common cause with proponents of eugenics, believing that she and they both sought to "assist the race toward the elimination of the unfit".[142]

Critics of Planned Parenthood often refer to Sanger's connection with supporters of eugenics to discredit the organization by associating it, and birth control, with the more negative modern view of eugenics.[143][144] Planned Parenthood has responded to this effort directly in a leaflet acknowledging that Sanger agreed with some of her contemporaries who advocated the voluntary hospitalization or sterilization of people with untreatable, disabling, hereditary conditions, and limits on the immigration of the diseased. The leaflet also states that Planned Parenthood "finds these views objectionable and outmoded" but says that it was compelled to discuss the topic because "anti-family planning activists continue to attack Sanger... because she is an easier target" than Planned Parenthood.[145]

Planned Parenthood has occupied a central position in the abortion debate in the U.S., and has been among the most prominent targets of the United States pro-life movement for decades. Some members of Congress, overwhelmingly Republican, have attempted since the 1980s to end federal funding of the organization,[58] nearly leading to a government shutdown over the issue in 2011.[146] Planned Parenthood has consistently maintained that federal money received by Planned Parenthood is not used to fund abortion services, but pro-life activists have argued that the federal funding frees up other resources that are, in turn, used to provide abortions.[58]

Planned Parenthood is the largest single provider of abortions in the U.S.,[147] but pro-choice advocates have argued that the organization's family planning services reduce the need for abortions; in the words of Megan Crepeau of the Chicago Tribune, Planned Parenthood could be "characterized as America's largest abortion preventer".[148][149] Pro-life activists dispute the evidence that greater access to contraceptives reduces abortion frequency.[150]

Periodically, pro-life advocates and activists have tried to demonstrate that Planned Parenthood does not follow applicable state or federal laws. The groups called or visited Planned Parenthood health centers posing as victims of statutory rape,[151] minors who by law need parental notification before abortion,[152] racist donors seeking to earmark donations to reduce the African-American population,[52][153] or pimps seeking abortions for underage prostitutes.[154] As a result of some of these videos, several Planned Parenthood workers have been disciplined or fired.[153][154] However, a 2005 review by the Bush administration'sDepartment of Health and Human Services "yielded no evidence of clinics around the nation failing to comply with laws on reporting child abuse, child molestation, sexual abuse, rape or incest".[152]

Beginning in 2010, Live Action has released several series of undercover videos filmed in Planned Parenthood centers. Live Action said one series showed Planned Parenthood employees at many affiliates actively assisting or being complicit in aiding a prostitution ring,[155] advising patients on how to procure sex-selective abortions,[156] and one who said they would immerse a child born alive after a botched abortion in a chemical solution to make it stop moving and breathing.[157] No criminal convictions resulted,[158] but some Planned Parenthood employees and volunteers were fired for not following procedure, and the organization committed to retraining its staff.[159] Additionally, one center was placed on probation.[160]

In 2015 an anti-abortion organization named the Center for Medical Progress (CMP) released several videos that had been secretly recorded. Members of the CMP posed as representatives of a biotechnology company in order to gain access to both meetings with abortion providers and abortion facilities. The videos did show how abortion providers made fetal tissue available to researchers although no problems were found with the legality of the process. Members of CMP were later indicted by a Texas grand jury on felony charges for tampering with governmental records, but the charges were later dismissed.[162]

All of the videos were found to be altered, according to analysis by Fusion GPS and its co-founder Glenn Simpson, a former investigative reporter for The Wall Street Journal. The CMP disputed this finding, attributed the alterations to the editing out of "bathroom breaks and waiting periods".[163] CMP continues to allege that the videos provide evidence that abortion providers profit from the sale of donated tissue. The videos attracted widespread media coverage, and after the release of the first video, conservative Congressional lawmakers singled out Planned Parenthood and began to push bills that would strip the organization of federal family planning funding. No such attempts by Congress to cut federal family planning money from Planned Parenthood have become law. Conservative politicians in several states have also used this as an opportunity to cut or attempt to cut family planning funding at the state level.

On January 25, 2016, a Texas grand jury indicted CMP founder David Daleiden and member Sandra Merritt while finding no wrongdoing by Planned Parenthood. The charges against Daleiden and Merritt were dismissed six months later.

In the U.S., abortion providers have been threatened with death, and facilities that provide abortions have been attacked or vandalized.[164][165] Planned Parenthood clinics have been the target of a number of instances of violence by anti-abortion activists, including bombing, arson, and attacks with chemical weaponry.[177] In 1994, John Salvi entered a Brookline, Massachusetts Planned Parenthood clinic and opened fire, murdering receptionist Shannon Elizabeth Lowney and wounding three others. He fled to another Planned Parenthood clinic where he murdered Leane Nichols and wounded two others.[178] In 2012, a Grand Chute, Wisconsin, Planned Parenthood clinic was subject to a bombing perpetrated by an unknown individual.[165] In 2015, a Planned Parenthood clinic in Pullman, Washington was heavily damaged by arson.[179]

On November 27, 2015, a gunman shot and killed two civilians and a police officer during a five-hour gun battle at the Colorado Springs, Colorado clinic.[180][181][182] The 57-year-old gunman,[183] Robert Dear, surrendered to police and was taken into custody. During his arrest, he gave a "rambling" interview[184] in which, at one point, he said "no more baby parts", echoing language used in the news media about the clinic following the Center for Medical Progress videos.[185][186][187] Dear was declared incompetent to stand trial for the shooting, citing experts' finding that he suffers from "delusional disorder, persecutory type."[188]

^Planned Parenthood dates its beginnings to 1916, when Margaret Sanger opened her first birth control center in Brooklyn. Its predecessor, the American Birth Control League, was founded in 1921, and the organization adopted the name Planned Parenthood in 1942.

^Planned Parenthood Advocates of New York, Issues & Positions. Access date June 24, 2016. Quote: "While Planned Parenthood supports and promotes communication between parents and their teens, requiring parental notification or consent would reduce the numbers of teens seeking care and put them in danger. We believe it is important for teens to have access to safe health care, even if they can't come to their parents for whatever reason. PPANY opposes government-mandated parental consent and parental notification requirements."

^* Finn, Robin, "Anti-Abortion Advocates? Bring 'Em On, Texan Says", The New York Times, March 10, 2006. Quote: "PLANNED PARENTHOOD serves five million Americans and concentrates 90 percent of its efforts on preventing unwanted pregnancies, Ms.Richards, says, not terminating them. 'No one does more to reduce the need for abortions in this country than Planned Parenthood.'"[1]

Also, Emily Stewart, director of public policy for Planned Parenthood said: "Without a doubt, when women have access to birth control, it reduces unintended pregnancies" [2]